| NPI | 1972795706 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F307582) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 17712) |
| Enumeration Date | 2007-08-15 |
| Last Update Date | 2016-05-16 |